Some Physicians Refuse To Accept Patients Enrolled In Medicare Advantage Plans

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Medicare Advantage Plans

With the Medicare openenrollment period ending at the end of the month, some physicians are sayingthat they will not accept patients enrolled in Medicare Advantage plans, the DesMoines Register reports. The Iowa Clinic and Minnesota's Mayo Clinic both are denying beneficiaries who areenrolled in most MA plans.

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Iowa Clinic CEO Ed Brown said that the facility will not accept MA plans thatreimburse at the same rate as traditional Medicare because the private plansreceive more funding from the federal government. A Mayo Clinic spokespersonsaid the clinic has a similar policy. CMS has confirmed that it pays MA planproviders about 12% more than traditional Medicare. MA plan providers say thatthey offer extra benefits and simplified paperwork, according to the Register.

Brown said that the Iowa Clinic will provide interim care for current patientswho have switched plans. Michael Kitchell, chair of the Iowa Medical Society, said that he agrees with the American Medical Association that MA plans are paid too much butthat he doubts many physicians in the state will follow the Iowa Clinic's lead.Kitchell noted that a bill in Congress would cut MA payments but that PresidentBush has threatened to veto it. Humana, which provides MA plans, has aprinted disclaimer that warns beneficiaries to make sure their physiciansaccept MA plans before signing up for it.

Sen. Chuck Grassley (R-Iowa) defended MA plans and labeled the physicians whorefuse MA plans as "spiteful." He said, "There's no way you canwin an argument with senior citizens by saying, as a doctor, 'I will take atraditional Medicare person that's going to pay me $100, but I'm not going totake anybody that's in MedicareAdvantage that's going to be paying me the same $100 because I don't likethe way the company may be making some more money'" (Leys, DesMoines Register, 12/9).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.

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